Discover and read the best of Twitter Threads about #NAFLD
Most recents (24)
El ayuno y el ejercicio son opciones simples implementables para prevenir trastornos metabólicos, actuando en sinergia para reducir el riesgo de obesidad, diabetes, hígado graso y enfermedades cardiovasculares.🫢🏃💨🏋️
#ECV #microbiota #NAFLD #restricción
doi.org/10.3390/nu1510…
#ECV #microbiota #NAFLD #restricción
doi.org/10.3390/nu1510…
📚En conjunto, mejoran los parámetros metabólicos, evitan la ganancia de peso, aumentan la sensibilidad a la insulina, reducen la esteatosis hepática y regulan el metabolismo de los lípidos.
registering DOI...🙄
Intermittent Fasting and Physical Exercise for Preventing Metabolic Disorders through Interaction with Gut Microbiota: A Review
mdpi.com/2072-6643/15/1…
Intermittent Fasting and Physical Exercise for Preventing Metabolic Disorders through Interaction with Gut Microbiota: A Review
mdpi.com/2072-6643/15/1…
Tony Ferrante MD PhD of @ColumbiaMed providing an excellent systems based overview of the "metabolic" complications of #obesity and potential mechanisms: lipotoxicity, inflammation, adipokines
Some highlights:
1/
Some highlights:
1/
Neurology:
Check out this relationship where higher BMI is associated with ↑ risk of #dementia EXCEPT in age >70 when it's better to be in "overweight" category
👉Aiming for a "normal BMI" is not the best goal for everyone
2/
Check out this relationship where higher BMI is associated with ↑ risk of #dementia EXCEPT in age >70 when it's better to be in "overweight" category
👉Aiming for a "normal BMI" is not the best goal for everyone
2/
The findings of this one suggest a possible defect in the transfer of PUFA from peripheral tissues to the liver in NAFLD, with HDL composition being tightly connected to the rewiring of hepatic PUFA composition that occurs in NAFLD.
- NAFLD was characterised by a depletion in phospholipids (phosphatidylcholines, phosphatidylethanolamines, phosphatidylglycerols and sphingomyelins) specifically driven by their PUFA fraction.
- NAFLD patients had higher saturated and lower polyunsaturated FFAs.
Using data from 4 different cohorts, this one found positive associations between sugar-sweetened beverages & low/no-calorie beverages intake and NAFLD, as assessed using the Fatty Liver Index (FLI) (≥60).
- The study used data from 42,024 participants from the Lifelines Cohort study (Lifelines; The Netherlands), the Nutrition Questionnaire Plus study (NQPlus; The Netherlands), the PREDIMED-Plus study (PREDIMED-Plus; Spain), and the Alpha Omega Cohort (AOC; The Netherlands).
- Harmonized data analyses of showed positive associations between sugar-sweetened beverages & low/no-calorie beverages intake intakes and FLI-defined NAFLD prevalence.
In this one, NAFLD, as assessed by the fatty liver index (FLI), was found associated with the risk of type 2 diabetes in Japanese adults.
* LP (linear predictor) = 0.953*ln[triglycerides (mg/dL)] + 0.139 * BMI (kg/m2) + 0.718*ln[GGT (IU/L)] + 0.053 * waist circumference (cm) - 15.745
* FLI = [e^LP/(1 + e^LP)] * 100
* FLI = [e^LP/(1 + e^LP)] * 100
- The FLI was positively associated with the risk of type 2 diabetes.
☪️ #4 and #5!
One of my personal favorite intersections: #Ramadan and #NAFLD
Things that are established: Ramadan fasting does not make fatty liver disease worse
But does it make it better?
The empiric answer would be YES, but how? let’s dive into the nuance
🧵1/
One of my personal favorite intersections: #Ramadan and #NAFLD
Things that are established: Ramadan fasting does not make fatty liver disease worse
But does it make it better?
The empiric answer would be YES, but how? let’s dive into the nuance
🧵1/
Observational data suggest that in patients with #fattyliverdisease, Ramadan tends to ⬇️ LFTs and ⬆️glycemic function
tinyurl.com/bdctcav8
Retrospective data seems to agree with this:
tinyurl.com/2nwd5zhc
These changes involve ⬇️ in A1c, BMI, and FIB4 scores❗️
2/
tinyurl.com/bdctcav8
Retrospective data seems to agree with this:
tinyurl.com/2nwd5zhc
These changes involve ⬇️ in A1c, BMI, and FIB4 scores❗️
2/
So the available data (though limited) establishes that Ramadan fasting seems to improve LFTs and leads to valuable reductions in disease-related indices like fibrosis scores
The more interesting question though, is
HOW❓🧐
3/
The more interesting question though, is
HOW❓🧐
3/
The findings of this one suggest that persistent de novo lipogenesis during fasting may at least partly explain impaired fasting ketogenesis in metabolic syndrome, which appears to be the consequence of reciprocal regulation of DNL and β-oxidation.
- Forty non-diabetic individuals with and without a history of NAFL were recruited for this study.
- Lipogenesis remained detectable in a subset of individuals after a 24 hour fast, including some subjects without hepatic steatosis or other hallmarks of metabolic syndrome.
Recommendations to enable and optimize a multidisciplinary approach in #NAFLD care. #livertwitter @AlinaAllenMD @AlkhouriNaim @JVLazarus nature.com/articles/s4385…
Evaluate benefit and cost-effectiveness of multidisciplinary models of care based on NITs, which should be adopted by first-line providers, such as PCPs and endocrinologists, and monitor their use. nature.com/articles/s4385…
Implement context-specific (prevention, screening, risk-stratification, treatment) and resource-specific (for low-, middle- and high-income settings) models of care and always report their effectiveness.
Back in the days of John Humphrey Noyes before he got suspended for posting a study indicating there's viral persistence in epithelium of kids, because everyone includes kids.
How does a twit like this get 108K views propagating “what if viral persistence is REAL”?
It’s almost like we are back to banning twitter accounts for insisting SARS is airborne!
It’s almost like we are back to banning twitter accounts for insisting SARS is airborne!
WHEN the rest of non-SARS experts acknowledge that “viral persistence is a thing”, we will be one step closer to acknowledging the true immunity dysfunction threat of SARS
#AirborneAIDS
#AirborneAIDS
Bart Staels, PhD of Univ of Lille, France gave an outstanding talk on Interplay Between #NAFLD & #CVD at the #WCIRDC. CVD is the leading cause of death not liver disease. Fibrosis severity correlates with higher CVD risk. @WCIRDC @YHandelsmanMD
healio.com/news/endocrino…
healio.com/news/endocrino…
Type 2 #diabetes and #NAFLD have a reciprocally injurious relationship mediated through common pathophysiology magnifying the risk for #CVD events.
pubmed.ncbi.nlm.nih.gov/33015726/ @zilbermint @AlinaAllenMD
pubmed.ncbi.nlm.nih.gov/33015726/ @zilbermint @AlinaAllenMD
#NAFLD is considered the hepatic manifestation of the metabolic syndrome and is closely linked to:
✅#Obesity, especially visceral adiposity
✅Insulin resistance
✅Chronic inflammation
✅#Lipotoxicity
nature.com/articles/s4141…
✅#Obesity, especially visceral adiposity
✅Insulin resistance
✅Chronic inflammation
✅#Lipotoxicity
nature.com/articles/s4141…
Using genome-wide association studies (GWAS) of large-scale whole-body MRI data, this one found substantial genetic correlations between body composition measures and a range of cardiometabolic diseases, with the strongest correlation between liver fat and type 2 diabetes.
Note that where you see MV in the pic above, it's muscle volume, MF is muscle fat infiltration and AFR is Abdmonal Fat ratio.
I think this legend here is more useful, so there you go, for easier comparison/lookup:
I think this legend here is more useful, so there you go, for easier comparison/lookup:
- "Our findings that a substantial portion of the genetic determinants of these measures are related to the immune system fit with a large body of literature...
In this one, mice fed an obesogenic high starch diet, although exhibited hyperglycemia and hyperinsulinemia, remained glucose tolerant and insulin sensitive despite having excess adipose tissue, in contrast to mice fed an obesogenic high-fat diet.
This is a pretty cool study delving further into the connection between ceramides, de novo lipogenesis and liver, muscle fat infiltration, the relationship between body fat content and insulin action and the effects of dietary manipulation in these factors.
- The current study reports on a dietary intervention that produces significant obesity but maintains normal insulin action in mice providing some mechanistic understanding of the phenomenon of obesity with preserved insulin sensitivity.
Now that's interesting.
This one in mice suggests that chronic glucagon agonist-mediated weight loss is due to low plasma amino acid availability, which results in increased energy expenditure and subsequent body weight loss.
This one in mice suggests that chronic glucagon agonist-mediated weight loss is due to low plasma amino acid availability, which results in increased energy expenditure and subsequent body weight loss.
- A long-acting glucagon analog led to glucagon-mediated body weight loss which was intrinsically linked to hypoaminoacidemia.
- Low plasma amino acids were found to be a pre-requisite for this glucagon-mediated energy expenditure and weight loss.
The findings of this one support that even plant-based unhealthy dietary choices can be harmful towards metabolic health, as they exhibit a positive association with liver steatosis prevalence.
- The overall plant-based dietary index (PDI), the healthful plant-based dietary index (hPDI) and the unhealthful plant-based dietary index (uPDI) were used to assess one's diet.
- The PDI corresponds to the overall adherence to a plant-based dietary pattern irrespective to the quality of plant-based products consumed.
In this one, muscle fat infiltration was found to be associated with a higher risk of NASH and significant liver fibrosis, regardless of muscle mass, function, or strength, in patients with severe obesity.
- The degree of NASH in liver histology presented as steatosis, and ballooning, and liver fibrosis was correlated with fat infiltration in the muscle assessed, the psoas.
- Psoas muscle fat infiltration was associated with a 2.3-fold increased risk for NASH and a 2.9-fold increased risk for significant liver fibrosis.
This one in Korean adults found individuals with a high sodium intake, as assessed by sodium excretion, to be more likely to have NAFLD, as reflected by the fatty liver index, and sarcopenia.
- Individuals with the highest 24-hour urinary sodium excretion showed a 46% higher risk of NAFLD.
- The risk was maintained independent of the presence of sarcopenia and was increased by up to 110% in the participants without sarcopenia.
Some classic genetic stories, and some more recent ones… #TLM22
I am a cardiologist, and my work place is above the diaphragm?! Why should I care about the #liver and #NAFLD (non-alcoholic fatty liver disease)?
⚡️Our therapies in many cases reach well beyond the heart
⚡️In order to improve outcomes we have to tackle comorbidities
A🧵
⚡️Our therapies in many cases reach well beyond the heart
⚡️In order to improve outcomes we have to tackle comorbidities
A🧵
🟦NAFLD (prevalence 25%) isn't only a hepatic disease but also a systemic & CV disease w/o effective pharmacotherapy
🟦We discuss the promising role of SGLT2i in NAFLD, propose mechanisms, & suggest future directions.
sciencedirect.com/science/articl…
🟦We discuss the promising role of SGLT2i in NAFLD, propose mechanisms, & suggest future directions.
sciencedirect.com/science/articl…
The pathogenesis of NAFLD is multifactorial w/ parallel processes that involve insulin resistance, hepatic fat accumulation, increased lipotoxicity, mitochondrial dysfunction, oxidative stress, ER stress, abnormal autophagy, altered gut flora, & apoptosis.
Let's review quickly all of the science I've come across in the past week that applies to high-fat ketogenic carnivore type diets.
I'll post the link, an image of the abstract, the title, and some hashtags on each one.
1/n - My public Zotero Database:
zotero.org/groups/2466685…
I'll post the link, an image of the abstract, the title, and some hashtags on each one.
1/n - My public Zotero Database:
zotero.org/groups/2466685…
2/n
Red and processed meat intakes and cardiovascular disease and type 2 diabetes mellitus: An umbrella systematic review and assessment of causal relations using Bradford Hill’s criteria
"do not support causality"
#T2D #CVD #SystematicReview #RedMeat
tandfonline.com/doi/full/10.10…
Red and processed meat intakes and cardiovascular disease and type 2 diabetes mellitus: An umbrella systematic review and assessment of causal relations using Bradford Hill’s criteria
"do not support causality"
#T2D #CVD #SystematicReview #RedMeat
tandfonline.com/doi/full/10.10…
Do #Vegetarian Diets Provide Adequate Nutrient Intake during Complementary Feeding? A Systematic Review
Complementary Feeding is the period when you're weaning a child onto non-breastmilk foods.
TLDR: "Not safe, critical micronutrient deficiency risk"
mdpi.com/2072-6643/14/1…
Complementary Feeding is the period when you're weaning a child onto non-breastmilk foods.
TLDR: "Not safe, critical micronutrient deficiency risk"
mdpi.com/2072-6643/14/1…
Session 2 of #AACECVMET that I'm attending is "Nonalcoholic Fatty Liver Disease: The Global Pandemic" by Dr. Scott Isaacs, MD (@EmoryMedicine)! #WeAreAACE
@EmoryMedicine Pathogenic drivers of NAFLD: genetics, epigenetics, dysbiosis, dysfunctional adipose tissue, insulin resistance, and calorie excess #AACECVMET
@EmoryMedicine All stages of NAFLD show increased mortality over a 30yr period, with mortality increasing with fibrosis stage #AACECVMET #NAFLD
Thyroid hormones regulate liver enzymes via thyroid hormone receptors. When the liver is steatotic, hepatic thyroid hormone receptors don’t respond effectively. This results in an intrahepatic hormonal milieu where the liver is essentially hypothyroid. #livertwitter #endotwitter
Thyroid hormone receptor-β plays a key role in hepatic homeostasis including:
✅De novo lipogenesis
✅Fatty acid β-oxidation
✅Mitophagy
✅Mitochondrial biogenesis
✅Cholesterol metabolism
✅Carbohydrate metabolism
#livertwitter #endotwitter
✅De novo lipogenesis
✅Fatty acid β-oxidation
✅Mitophagy
✅Mitochondrial biogenesis
✅Cholesterol metabolism
✅Carbohydrate metabolism
#livertwitter #endotwitter
Thyroid hormone receptor-β agonism has demonstrated clinical benefits on hepatic lipid metabolism.
frontiersin.org/articles/10.33…
frontiersin.org/articles/10.33…
Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t work right. #HepaticHypothyroidism
Hepatic enzymes responsive to #thyroid hormones will slow down when the liver is fatty. Thyroid hormone has a dominant effect on HMG-CoA reductase in the liver which regulates cholesterol levels which is why #hypothyroidism causes high cholesterol. #HepaticHypothyroidism
Thyroid hormone regulates fatty acid β-oxidation in the liver. This is a process that breaks down fat for energy. #NAFLD impedes the process in a viscous cycle where liver fat continues to build up, energy levels plummet, unresponsive to thyroid hormone. #HepaticHypothyroidism
1a) Welcome to one of our favorite events on the @academiccme #accredited #tweetorial feeds: a takeover of our programming from @GoggleDocs! The focus of this tweetorial is data from #ADA2022 on #SGLT2i beyond cardiac disease. Our expert author is @GoggleDocs' @drpatrickholmes.
1b) Check out our other #ADA2022 recap #tweetorial by new @GoggleDocs family member @Ines_VFonseca who focused on the cardiac data presented: ckd-ce.com/dkd13_ada22a/
2) This program is #accredited for CE/#CME #physicians #physicianassociates #nurses #pharmacists #nursepractitioners & is supported by an educational grant from the Boehringer Ingelheim Pharmaceuticals Inc and Eli Lilly Company. It is intended for healthcare professionals.
This one suggests that non-invasive methods to assess body fat can be used to predict NAFLD, and even though there are differences between men and women, this is not true for racial/ethnic groups.
- "The current study found that body fat and anthropometry were good predictors of NAFLD; however, the best predictors were measures of abdominal size (total abdominal fat, waist circumference, WHR [waist to height ratio]) among men and visceral fat among women...
"...The predictions did not vary greatly by race/ethnicity."
